Nonsurgical treatment of an adult with a skeletal Class II gummy smile using zygomatic temporary anchorage devices and improved superelastic nickel-titanium alloy wires

2017 ◽  
Vol 152 (5) ◽  
pp. 693-705 ◽  
Author(s):  
Yuji Ishida ◽  
Takashi Ono
Keyword(s):  
Titanium Alloy ◽  
Class Ii ◽  
Nickel Titanium ◽  
Nonsurgical Treatment ◽  
Skeletal Class ◽  
Temporary Anchorage Devices ◽  
Skeletal Class Ii ◽  
Gummy Smile

scholarly journals Treatment of Class II Protrusion with Severe Crowding Using Indirect Miniscrew Anchorage

2007 ◽  
Vol 77 (6) ◽  
pp. 1109-1118 ◽  
Author(s):  
Nak-Chun Choi ◽  
Young-Chel Park ◽  
Han-Ah Lee ◽  
Kee-Joon Lee
Keyword(s):  
Class Ii ◽  
Chief Complaint ◽  
Nickel Titanium ◽  
Nonsurgical Treatment ◽  
Facial Profile ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Chief Complaints ◽  
Movement Mechanics

Abstract This report describes the nonsurgical treatment of a patient with skeletal Class II protrusion and severe crowding. A 20-year-old woman presented with the chief complaint of lip protrusion and crowding. To correct the Class II relationship, severe crowding, and lip protrusion, distal movement of the maxillary first molars using indirect miniscrew anchorage and nickel-titanium coil springs, along with extraction of the first premolars and maxillary second molars, was planned. After the distal molar movement phase was complete, the maxillary first molars had moved 8.0 mm to the distal, and the first premolars, which were splinted to the miniscrews, had moved 0.5 mm to the mesial. The results show that the distal molar movement mechanics were efficient and stable. After treatment, all of the patient's chief complaints were relieved and an esthetic facial profile was obtained.

scholarly journals Gummy smile and facial profile correction using miniscrew anchorage

2011 ◽  
Vol 82 (1) ◽  
pp. 170-177 ◽  
Author(s):  
Masato Kaku ◽  
Shunichi Kojima ◽  
Hiromi Sumi ◽  
Hiroyuki Koseki ◽  
Sara Abedini ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Therapy ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Retention Period ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Profile Correction ◽  
Gummy Smile

Abstract This case report describes the treatment of a case involving a skeletal Class II facial profile with a gummy smile. While treating a facial profile and a gummy smile, the outcome may not always be successful with orthodontic therapy alone. For this reason, surgical therapy is often chosen to gain an esthetic facial profile and a good smile. However, sometimes the patients reject surgical treatment and an alternative method must be considered. Skeletal anchorage systems such as miniscrews are now frequently used for correcting severe malocclusion that should be treated by surgical therapy. In this case report, we treated a skeletal Class II malocclusion with a convex profile and a gummy smile using miniscrews, which were placed in the upper posterior and anterior areas. The active treatment period was 3.5 years, and the patient's teeth continued to be stable after a retention period of 36 months.

scholarly journals Republication: Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine

2018 ◽  
Vol 8 ◽  
pp. 146-160
Author(s):  
Ariel Wong ◽  
Chris Chang ◽  
W. Eugene Roberts
Keyword(s):  
Conservative Management ◽  
Anterior Segment ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Maxillary Canine ◽  
Deep Bite ◽  
Fixed Appliance ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Gummy Smile

A 21-year-old female presented with chief complaints of crooked teeth, canine impaction, deep bite, and “gummy smile” (excessive maxillary gingival exposure when smiling). Increased facial convexity (15.5°), increased lower facial height (56%), and incompetent protrusive lips (E-line to upper left 2 mm, E-line to lower left 2 mm) were associated with a severe Class II malocclusion (nearly a full cusp bilaterally). There was 7.5 mm of overjet, 100% anterior deepbite, and a left posterior buccal crossbite. Cephalometrics revealed a skeletal discrepancy due to a protrusive maxilla and a retrusive mandible (SNA 85°, SNB 78°, and ANB 7°). Cone-beam computed tomography imaging revealed a palatally impacted right maxillary canine (UR3) near to the adjacent lateral incisor (UR2). The retained right primary canine (URc) was extracted. A simplified open-window technique was utilized to surgically expose its impacted successor. A maxillary anterior mini-screw provided anchorage to align the UR3 in its correct anatomical position. Nonextraction treatment with a passive self-ligating fixed appliance was indicated to align and level both arches. Anchorage provided by infrazygomatic crest bone screws, and maxillary anterior miniscrews were used for the correction of Class II malocclusion and gummy smile. To achieve more esthetic crown lengths in the maxillary anterior segment, gingivectomy was performed with a diode laser 2 months after fixed appliances were removed. This challenging skeletal Class II malocclusion with a Discrepancy Index of 38 was treated in 32 months to excellent outcomes: Cast-radiograph evaluation score of 25 and an pink and white dental esthetic score of 2. All facial and dental corrections were stable at the 6 months follow-up evaluation (Int J Orthod Implantol 2017;48:24-46). Republished with permission from: Ariel Wong, Chang CH, Roberts WE. Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine. Int J Orthod Implantol 2017;48:24-46.

scholarly journals A comparison of the effects of Forsus appliances with and without temporary anchorage devices for skeletal Class II malocclusion:

2020 ◽  
Author(s):  
Lu Liu ◽  
Qi Zhan ◽  
Jing Zhou ◽  
Qianyun Kuang ◽  
Xinyu Yan ◽  
...  
Keyword(s):  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Temporary Anchorage Devices ◽  
Skeletal Class Ii ◽  
Nasolabial Angle ◽  
Mean Differences

ABSTRACT Objectives To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion. Materials and Methods Through a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations. Results Electronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were –0.27 (95% confidence interval [CI]: –0.59, 0.05) for SNA, 0.58 (95% CI: –0.07, 1.23) for SNB, –0.86 (95% CI: –1.74, –0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, –7.56 (95% CI: –11.37, –3.76) for L1-MP, 0.47 (95% CI: –0.98, 1.91) for overjet, 0.39 (95% CI: –0.57, 1.35) for overbite, –1.84 (95% CI: −5.15, 1.47) for SN-OP, and 4.97 (95% CI: –1.22, 11.17) for nasolabial angle. Conclusions TADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.

scholarly journals Treatment of vertical maxillary excess without open bite in a skeletal Class II hyperdivergent patient

2017 ◽  
Vol 87 (4) ◽  
pp. 625-633 ◽  
Author(s):  
Cheol-Ho Paik ◽  
Hong-Sik Park ◽  
Hyo-Won Ahn
Keyword(s):  
Orthognathic Surgery ◽  
Class Ii ◽  
Open Bite ◽  
Posterior Teeth ◽  
Skeletal Class ◽  
Curve Of Spee ◽  
Skeletal Class Ii ◽  
Temporary Anchorage Device ◽  
Transpalatal Arch ◽  
Gummy Smile

ABSTRACT A 20-year-old woman visited the office complaining of a gummy smile and lip protrusion. She was diagnosed with vertical maxillary excess without open bite and skeletal Class II hyperdivergent pattern. She refused the surgical-orthodontic treatment option, although she wanted to correct the gummy smile and retruded chin. Differential intrusion of anterior and posterior teeth in both arches was necessary to maximize the skeletal treatment effects. In the maxilla, one palatal temporary anchorage device (TAD), an archwire with an accentuated curve of Spee, and a transpalatal arch were applied. In the mandible, an archwire with a reverse curve of Spee and two vertically positioned TADs were used. These simple mechanics contributed to the effective intrusion of the total upper and lower arches, correction of the gummy smile, and mandibular counterclockwise rotation, offering an alternative to orthognathic surgery for this patient.

Nonsurgical Treatment of Skeletal Class II Patient with Constricted Anterior Arch

2021 ◽  
Vol 11 (3) ◽  
pp. 228-242
Author(s):  
Ha-eun Moon ◽  
Hyunmin Kim ◽  
Mirinae Park ◽  
Gyu-Hyeng Lee ◽  
Min-Hee Oh ◽  
...  
Keyword(s):  
Class Ii ◽  
Nonsurgical Treatment ◽  
Anterior Arch ◽  
Skeletal Class ◽  
Skeletal Class Ii

scholarly journals Camouflage of Severe Skeletal Class II Gummy Smile Patient Treated Nonsurgically with Mini Implants

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Irfan Qamruddin ◽  
Fazal Shahid ◽  
Mohammad Khursheed Alam ◽  
Wafa Zehra Jamal
Keyword(s):  
Case Report ◽  
Class Ii ◽  
Skeletal Class ◽  
Mini Implants ◽  
Skeletal Class Ii ◽  
Soft Tissue Profile ◽  
Smile Esthetics ◽  
Gummy Smile ◽  
Lower Incisors ◽  
Composite Restoration

Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by general practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.

An Innovative Procedure for Lip Lengthening in a Patient with a Short Upper Lip and High-Angle Skeletal Class II Pattern: A Case Report

2021 ◽  
pp. 030157422110076
Author(s):  
Mukesh Kumar ◽  
Manish Goyal ◽  
Jha Bhavna ◽  
Sumit Tomar ◽  
Ashish Kushwah
Keyword(s):  
Orthognathic Surgery ◽  
Surgical Intervention ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Upper Lip ◽  
Skeletal Class ◽  
Temporary Anchorage Devices ◽  
Innovative Method ◽  
Skeletal Class Ii ◽  
Treatment Alternatives

Skeletal class II malocclusion in adult patients with severe gummy smile is challenging for orthodontist and often requires surgical intervention. The difficulty increases when patients refuse orthognathic surgery, and orthodontists have limited treatment alternatives. This report describes the case of a patient with severe dento-skeletal class II malocclusion with excessive gingival display while smiling. The patient was treated with temporary anchorage devices, and an innovative method of lip repositioning was devised to correct the irregularity.

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